living and growing after baby loss

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“A miscarriage is lonely, painful, and demoralising almost on a cellular level.” Michelle Obama, Becoming

The remarkable and accomplished former first lady’s candid statements about her personal loss are welcomed by many of us who have had the common, and often emotionally devastating, experience of miscarriage. By including this part of her life in her new book, Ms. Obama has helped to continue to push open the door to this national discussion about how we are affected by perinatal loss and what can help.

In an attempt to add a bit to this conversation, I’m attaching the following excerpt from my book At a Loss: Living and Growing After Miscarriage, Stillbirth and Infant Death. I think the technical term for my book at this moment might actually be manuscript, but it is complete and I’m working to find the right publisher. I’d like to also take this opportunity to extend a big thanks to everyone for your support of this project– your words and faith in the book have meant a lot to me.

I don’t need a cloak to become invisible. —J. K. Rowling, Harry Potter and the Sorcerer’s Stone

“We had a family gathering, and no one mentioned the baby.”

“It’s been weeks since anyone checked in with me to see how I’m doing.”

“I told my friend I was having a hard day, and she said she couldn’t understand why I was still so upset.”

When I was in my early twenties, one of my best friends lost her second child. She was at full term with a baby boy and found out just before delivery that he had passed away. I had recently moved from the Midwest to California and learned all of this from a distance. As the details came in, I was sad, horrified, and uncomfortably helpless. I was also, unfortunately, too naïve to really understand or empathize.

As a young, single woman who had no experience with pregnancy or parenting, I could only try to imagine what my friend was going through. It seemed surreal, like something that would happen to people I didn’t know. My heart ached for her, and I repeatedly made brief, awkward attempts to express my sympathy over the phone.

As I heard that my friend had named her son, visited his grave daily, and spent much of her day crying, I felt sympathetic—and then, within weeks, a bit uncomfortable and even judgmental. When the weeks turned into months, I continued to reach out with periodic, strained attempts at conversation, while my internal judgments grew louder. It seemed strange to me that she would grieve so intensely for someone who (I believed) had never truly been in the world. She didn’t really know him, right? She already had one living child and certainly could expect to have more. Could she be making too much of her loss? Was she somehow making it worse? Might she be committing the crime (as we Midwesterners tend to see it) of being raw and open about intense feelings?

Kenneth Doka coined the phrase “disenfranchised grief” to refer to the pain of certain types of losses that are commonly unrecognized or minimized by society. These include losses that society views negatively, such as loss of a loved one through suicide, and those that are somehow hidden, such as a miscarriage.

Another type of perinatal loss that happens to some of us are terminations due to a prenatal diagnosis, such as a chromosomal abnormality that is incompatible with life or seriously threatens the quality of life. These losses are often experienced as a disenfranchised grief. Abortion—even when it may not feel like a choice—is a loss that many in our circle may view negatively. It may lead those of us in this situation to not even tell friends or family about our pregnancy or how and why it ended.

Support from family, friends, and even strangers is one of the ways we humans get through grief. When you have to grieve without these expressions of care and concern, you may feel the added burden of isolation on top of the loss. If other people don’t validate your strong feelings, you may feel ashamed of them. You are, in a sense, grieving without permission and without the recognition that your loss warrants a full experience of mourning.

Sometimes the expression of care isn’t missing; it’s inauthentic or inept. This, too, can add to your pain and suffering. To my knowledge, no one has ever felt helped by hearing (or sensing from their friend’s unspoken communication) that she is overreacting to the loss of her baby. Grief is not a disease, it’s not a choice, and it’s certainly not something we can be talked out of.

In those moments when people just aren’t there for you, or when they minimize your pain, it can help to know that it may be because they just don’t understand your grief experience. It can also help to know that awareness of baby loss is growing and that whether or not you have met them yet, there are people on your planet who understand why you are feeling the way you are feeling.

Your loss is understandably devastating, and it may be taking up much of your energy. You are having your own experience of grief, and you don’t have to spend extra energy worrying that you are doing it right in the eyes of others. As Joanne Cacciatore writes in Bearing the Unbearable, “…if grief is a disease, so too must be love.”

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“Taking steps is easy/Standing still is hard” Regina Spektor, You’ve Got Time

“Just for a moment, let’s be still.” The Head and the Heart, Let’s Be Still

In the first couple of weeks after I lost my baby, I wrote some poems. Prior to that time, I hadn’t written poetry since high school and never voluntarily. It was not and is not “my thing”.

One of my poems was basically a fantasy about how I could have “fought back” against the events at the hospital after getting the news that something was going wrong with my pregnancy. In my reimagined version, instead of cooperating with the medical monitoring to determine that my baby had no heartbeat, having labor induced and allowing myself to be escorted through the labor and delivery process, I instead overturned the equipment, picked up a rock and then used it to shatter the scene.

Looking back over 14 years later, I can read a lot into that poem. But the visceral memory and accompanying word that stands out for me today is vulnerable. I remember lying in the hospital bed feeling emotionally and physically exposed to the elements. It was this state that preceded and led to those thoughts about fighting back. I remember sensing that I had no defenses, no power and had no ability to do anything of consequence.

Baby loss puts us in a state of vulnerability. Not the kind of vulnerability where we may choose to take a risk in the service of personal growth. More like the ground shaking beneath your feet, house spinning in the tornado, canoe going over the waterfall version of vulnerable. It’s involuntary and overwhelming.

When we are in such a place, we are beyond protecting ourselves in the usual and customary manner. The walls are down throughout the castle and the bad thing can find us. It may be loss, hurt, trauma or all of the above.

After losing a baby, we may (consistently or episodically) have a strong impulse to do something. We may have a strong desire to undo our loss, however unrealistic that may be. We might feel a need to take the advanced placement course in grief so we can do it faster and better and get back to the life we were expecting. We may have an impulse to make a quick decision to begin trying again for another baby. Or maybe we feel compelled to return to work as soon as possible in order to bury ourselves in something other than the pain and fear that is our grief.

It is perfectly understandable that at such a time, we may feel a need to take action and we may need distractions.

We may also at times need something much quieter to help us heal ourselves.

If you’ve ever taken a yoga class, you probably remember the final pose called Savasana or “the corpse” pose. After whatever style and duration of practice–complete with conscious breathing, seeing the world from different physical perspectives and stretching with varying intensity– we are instructed to lie down on our backs with eyes closed, limbs loose, palms up and to release any remaining tension in the body.

From a physical point of view, the corpse pose seems to be one of extreme vulnerability. We choose to temporarily make ourselves immobile and blind while stretched out on the ground among other people. Our hands are empty and open. And rather than being vigilant about the whole thing, we are instructed to relax. It’s a seemingly simple exercise that can go deep. Some say it is a time to let the mind and body process what has happened in the session. Some say it is a time to focus on nothing and meditate without the distraction of movement. I’ve heard more than one teacher call it the hardest pose.

Richard Rosen, in the online version of Yoga Journal (Aug 2007), states that “in corpse pose, we symbolically ‘die’ to our old ways of thinking and doing”. He also advises us to “Remember the words of the great sage Abhinavagupta: ‘Abandon nothing. Take up nothing. Rest, abide in yourself, just as you are.’”

After my loss, I was not so much into the idea of abiding in myself. I wanted to resist what had happened. Failing that, I wanted to do something to rush through the awful looking season of grief in front of me. I’ve seen this look and impulse now in so many faces– the one that says “I need to get out of this feeling- NOW.”

Following a drastic injury to our lives, we may experience the need to fight back with all we have. Not taking action may feel weak, and exacerbate a sense of vulnerability. If grief is going to be a long journey, we may feel like we should hurry up and get on with it. But despite the rush to feel something else, there might be reasons to take a moment to slow down or be still.

After having our heart broken we usually aren’t ready to be in the fast lane for anything. It’s hard to heal when we’re always in motion. And grief is known to be a generally exhausting time in which we need fewer responsibilities and more support. We need time to rest and time to consider how to tend to ourselves in our lives without our babies. We also need to practice bearing our feelings, not just avoid them. What may seem like a time of extended vulnerability may actually be a time of gathering strength.

So whether we see it as a time to practice getting stronger, a meditation or just taking a knee in respect for the part of us that is gone, we may need to find a way to pause and be with ourselves for a bit. We may even need to lie down and let the ground hold us as we practice just being. We may need to have times where we see former parts of ourselves die just a little and witness the passing before considering the next part of life.

“You can kiss your family and friends good-bye and put miles between you, but at the same time you carry them with you in your heart, your mind, your stomach, because you do not just live in a world but a world lives in you.” Frederick Buechner

Pregnancy’s ineluctably relational nature means that once it begins, it can never be completely negated… In any case, in any outcome, there is a relationship the woman has to do something with– mourn it, celebrate it, try to forget it, dismiss it, accept its loss. Daphne de Marneffe, Maternal Desire: On Children Love and the Inner Life

Family trees are overrated. That’s my opinion about the traditional ones anyway– the kind that kids are asked to do in school and the ones touted on ancestry websites. I get that they can be useful for teaching us something about where we come from and some of the characters in our family history. I understand that the information may be rather poignant or interesting (e.g. my first relative to enter this country was a stowaway on a ship– I love to travel on the cheap– any meaningful connection there?). But when the background of our clan is drawn up in terms of births, deaths, marriage and divorce only, it seems to me to be a skeleton– with some bones missing– view of a family. There’s just a whole lot that remains unseen.

Maybe you were raised by your Aunt Fanny or your grandparents. Maybe your parents forgot to get married or divorced. Or maybe your parents couldn’t get married or you were conceived with the help of what psychologist Dianne Ehrensaft terms a “birth other” (donor or surrogate) or have more or less than two parents who are raised you. The authorities who track the comings and goings of our lives are likely to miss such details. The lines running between our hearts and those we love may be very different than what shows up on a traditional family tree.

Historically and today, a baby loss may not be noted in a family record. Depending on whether the loss was during or after pregnancy, whether a birth or death certificate was made and who all was told, it may be an off the books experience. The fact that it may go undeclared and unwritten matches the ambiguous quality that can be a part of baby loss.

Not every pregnancy loss is seen as a loss of a person and it doesn’t need to be. We each have an individual understanding of our loss and may hold it as more of a loss of a dream or a version of one’s future. Even infant loss, depending on cultural and individual differences, may be viewed as something less than would the loss of another family member.

But even when the occurrence is documented minimally or not at all, a baby loss still shakes the family tree.

Perinatal loss is often felt as a family crisis at multiple levels. When a baby is expected or recently arrived, new tendrils of feelings come out of family members. The feelings may be simply love or something more complicated, but a course is charted for a relationship and its accompanying emotions.

When a baby dies, everything changes. After excitement, planning and attachment, there is a space. There may be very traumatic memories and almost certainly very sad ones. There is hurt and shadow hanging over at least some of the family members. There may be a name that will rarely be said, family pictures that will have someone missing and ongoing relationships that will not develop.

All the hopes and dreams of one part of the family story are altered. The identities of mother, grandmother, uncle, etc are questioned or shifted as family members consider how a place will or will not be held for the baby in the family history. The ambiguity of a relationship starting and not continuing in a tangible manner may lead people to minimize the experience, but that won’t make it a non-event. The loss to the family at large of a baby may be a confusing experience to articulate, but that doesn’t diminish the reverberations.

One consequence of a baby loss might be the test of our family member’s emotional responses in time of crisis. We often have years or decades between big moments of birth and death, coming and going, beginnings and endings in a family. Baby loss may trigger a sense of fast forwarding through these types of experiences. We attach and change, grieve and stumble, show up for each other or don’t.

As with any loss in the family, we also run the experiment of testing out whether our mourning can be done while we stay connected to life and to each other. We find out if we can be open to joy again as we still grieve. Expecting and losing a baby makes us trot our heart quickly through its paces of the highs and lows of love.

At the end of it all, as the old bumper sticker tells us, love is what makes a family. All of this family drama may include family of various descriptions. The VIP list in your heart and star placement on your family tree can always include a list of less than traditional players. It could include the teacher who changed your life, your AA sponsor or your best friend.

Your family tree may also proudly feature someone you never met. It may include someone who changed you both physically and emotionally and taught you about attachment, priorities and loss. It may be the person whose presence made you both a mother and a bereaved person. It may be someone you never held, but who you will always hold close.

“I don’t even know what I would have wanted someone to say. Not: It will be better. Not: You don’t think you’ll live through this, but you will. Maybe: Tomorrow you will spontaneously combust. Tomorrow, finally, your misery will turn to wax and heat and you will burn and melt till nothing is left in your chair but a greasy, childless smudge. That might have comforted me.” Elizabeth McCracken, An Exact Replica of a Figment of My Imagination

I went through one of those trap door rabbit holes in cyber space the other day and ended up reading about the Temple at Burning Man. Burning Man, of course, is the yearly art festival in the Nevada desert that is famous for a number of things, including the practice of setting fire to many of the art pieces. My only experience at Burning Man was in 2014. There were a million bits of wonder and feeling that came up for me in my time there. It’s quite an event. Look at pictures from any year and you’ll get an idea of what I’m talking about.

A participant may see a giant Golden Dragon with beautiful people on board partying at sunrise, flying zoetrope monkeys powered by drumming and a Barbie Death Camp. In this gift economy, someone may offer to write the theme song for your life or make a sundae on your tongue. You may get stuck in a sandstorm which leaves you stranded and disoriented and when it clears, a stranger may come along and offer you the best grilled cheese sandwich you’ve ever had– it’s kind of like that. And, because someone else is bound to tell you if I don’t, I should say that there are a fair amount of nude people. Also, it’s hot, really hot. Did I mention that it takes place in a desert?

Since 2000, one of the traditions at Burning Man has been the construction of a temple. Various architects, the most well-known being David Best, have designed a different wooden creation every year. Like may things at Burning Man, it is done on a grand scale. The physical construction begins off site months before the event and continues on site in the weeks leading up to the festival. Built to last only a brief time in an intense environment, every year the temple seems to be an extremely well thought out, intricate and gorgeous structure.

During the festival, the Temple is a gathering place of memory and reflection. People bring pictures, personal belongings, and letters. Pens and markers are available for writing on the wood. It gets filled up with the space between the living and the dead. It is a place of feeling and remembrance and is often packed with people walking, sitting, and lying down inside the walls. During the week of the festival, it feels like an inviolate and solemn place. And on the last night of the event, it burns.

Like other burns, it is done at a specific time, after it is emptied out and sealed up, with tens of thousands watching from a safe distance, feeling whatever they are going to feel. People talk about it as a release, a spiritual catharsis. It’s whatever you need it to be.

The McCracken quote above is from a book written about her experience of having a stillborn son. This passage made me think about Burning Man and the Temple. At first I wondered what about being told that you will be melted down could be comforting. After baby loss, isn’t a person already so hurt and distressed that losing more of themselves is what they fear most?

But after considering McCracken’s words, I wonder if she is saying simply that it would take a dramatic, destroying image to resonate with what she felt inside. Maybe she was responding to the knowledge that her pain wasn’t a brief illness that she would temporarily dip in and out of, but rather a loss that would take much more of her than that. Maybe only a gutted, burnt out metaphor was a match for what she felt and the place she would be coming from to face whatever was next. Maybe what she could identify with most was the idea of burning through every feeling and being taken down to almost nothing.

I wouldn’t confuse this with hopelessness. A forest cleared by fire will have a next stage of growth. A person who hurts to his or her core will still eventually let in new bits of life. And every year a desolate playa in Nevada turns into a giant, vibrant city.

The time I went to Burning Man, the temple was filled with pictures, handwritten letters, pieces of cloth, at least one pine cone and some stuffed animals. Robin Williams had just died, and there were several areas with his picture and notes to and about him. There were goodbyes written on the walls to every kind of loved one. There were memorials to pets. There were pictures of moms, dads, grandparents and the kind of friends that are family.

There were small items meant for newborns. There were photographs of and names of babies, notes to and about the ones who didn’t make it into this world as well as infants who were no longer living.

On the last night, I pedaled to the temple burn at sunset along with others on foot or on bike–past the ashes from another burn, then a metal octopus, a miniature log cabin on wheels, a big group of people in sailor suits, a line of giant teapots strung together and some people sitting inside a neon star.

When I saw the temple burn, the first change I noticed was a soft orange glow inside, then flames outside. The smoke moved softly and adamantly in one direction. The moon looked tiny. Everything seemed to slow while a small corner of the desert burned down into something else.

“It was the best of times, it was the worst of times…” Charles Dickens, A Tale of Two Cities

“I’m sorry, Gemma. But we can’t live in the light all of the time. You have to take whatever light you can hold into the dark with you.” Libba Bray, A Great and Terrible Beauty

Last weekend I stayed at an off the grid hot springs establishment where the bathrooms were labeled “yin” and “yang”. I’m used to figuring out that I’m supposed to head for doors marked “Damas” or “Cowgirls” etc., but this was a nice spin on the concept. It turns out that sometimes a trip to the toilet in a beautiful and quirky location is a good opportunity to consider the relationship between the opposing sides of life.

Wikipedia gives us this: In Chinese philosophy yin and yang (also yin-yang or yin yang, yīnyáng “dark—bright”) describes how opposite or contrary forces are actually complementary, interconnected, and interdependent in the natural world, and how they give rise to each other as they interrelate to one another. Sometimes people talk about the two sides as male and female, fire and water, passive and active, moon and sun, etc. The symbol has, in the form of a dot, a little bit of the opposite color, reminding us that each side contains a bit of the other element.

The experience of expecting or having a baby and then losing that baby tends to give us a dizzying trip to both the light and dark side of life. It’s often a steep drop from one extreme to the other: joy-sadness, expecting-disbelief, hopeful-hopeless, assured-anxious, expansive-contracted, connecting-detaching, full-empty, beginning-ending. Certainly none of these feelings are unique to baby loss. But babies tend to bring out our strongest and most tender feelings, and the abrupt and dramatic shift related to attaching to them and losing them is particularly stunning.

The outlier moments in our life, those that are bigger– whether bright or dark– demand notice. They take our energy and attention and become landmarks in our memory. The two halves of the spinning, messy embrace we see in Yin and Yang symbol remind me of times when I have felt the opposing sides of my own life experience.

I have a memory of being five months pregnant on an Easter Sunday. I was lying on a lounge chair in the backyard of my then home feeling the sunshine on my skin and the movements of my baby inside me. At that moment everything felt connected and right.

I have memories of being in the hospital a couple of weeks later and feeling that I was losing more than I could handle. People mentioned how beautiful the weather was outside and I remember thinking that they must be living on another planet. I wondered if anything could feel OK again.

At the time, the two experiences seemed worlds apart. As I think about this now, it seems clear that it was two sides of me loving and losing someone dear to me. The memories now are held as interrelated and coexist as important part of my life.

When we are in a great place, it can help to remember a little about the other side and appreciate our time away from it. When in a tough place, it can help to remember the light of past and future, and that it’s as real as anything else. If we are in pain, it’s our time to breathe through the experience until we find another feeling. If we are in the best of times, it’s time to breathe it in, noticing the hell out of it because we will need some in reserve pretty soon.

Whether it is a time of celebrating or grieving, thriving or enduring, I think there is something to gain in being aware of what lies on the other side of the line (and the dot that is a little bit on our side). We can appreciate knowing there are limits to whatever we are feeling now, knowing at some point the game of tag will continue and the other side will be “it”. Being aware that there is a finite time when we’re in the worst of our pain makes it bearable. And remembering that our time on the sweet side is temporary can help us savor it a bit more.

“The past is never dead. It’s not even past.” — William Faulkner, Requiem for a Nun

“She took a step and didn’t want to take any more, but she did.”— Markus Zusak, The Book Thief

“It’s neither kind nor effective to bitch-slap yourself into a better way of living.”— Your Exquisite Self-Care Inventory –101 Ways to Love Yourself More Deeply from Life After Tampons Blog by Jennifer Boykin

About a decade ago, there was a morning where I found myself eating breakfast in a hotel ballroom in another part of the country while a speaker (whose name I can’t remember) stood at the podium and talked about exquisite self care. The audience for the conference was a mix of people who had experienced perinatal loss and those whose work focused on perinatal bereavement. The woman doing the keynote that morning promoted the idea of exquisite self care as necessary for coping with grief and as well as for working with those who are grieving. She spoke about accepting and validating increased needs after a significant loss, and suggested creative and heartfelt ways to increase both practical and emotional support in one’s life.

I remember liking the word exquisite being used in this way– it added an element of relief to picture something of beauty, sensitivity and discrimination associated with what can feel like the belly crawling time of coping with acute grief. I understood her premise to be that individuals can cultivate self-compassion and enlist it, along with other types of efforts, to stay afloat in the world. It expanded my idea of the long hard slog people can have with the basics of eating, sleeping, safety and support after a loss. The word exquisite made me consider space and grace seeping into the herculean efforts of those who are in crisis and who are attempting to get through the next moment or hour.

Exquisite self care also seems appropriate for attending to another need after baby loss, one that goes beyond the usual understanding of basic practical and emotional requirements. It’s something less tangible and probably presents uniquely to each person. I’m talking about how we care for the bits of involuntary interior remodeling of the self that happen after we lose our babies.

This remodeling may be big or small, have short or long term aspects and, sort of like the Winchester Mystery House, it may be ongoing. For some of us, we may feel a permanent change in the internal landscape. My own experience has been feeling that something was dug out inside me as a result of my losses and that the space has undergone many shifts. Early on, it was more like a situation room. Everything inside vibrated with intense feelings while plans were made, scrapped, and made again to deal with the circumstances at hand.

Now I think it’s more a room of requirement, a la the one found in Harry Potter’s Hogwarts. It fits the needs I have for it at different times. Sometimes it is a place where I meet others to hear and feel their stories and sometimes it is a place for me to sit with my own memories. It is simultaneously a space and an addition. It is a part of me shaped by a painful and significant part of my history.

Exquisite self care sounds like an appropriate way to tend to such a place. Some things are forever removed from the interior self post loss and some things should never be removed. It is a place deserving of respectful tending, which means not overlooking it, fearing it or forcefully messing with it. We look after it by gently looking inward. Sometimes we may nod to the space, make a quick round with a dust rag or take a minute to notice the current furnishings. Maybe other times we pull up a chair and sit awhile because something leads us there and it’s a fine place to visit.

Either way, a bit of tenderness and awe would not be out of line here. We can show some deference for our selves shaped, but not taken down by grief. We can remember our dreams and our babies and respect that we loved them and ourselves enough to make room for them.

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“I think about calling a friend sometimes, but I’m not sure anyone wants to spend time with me right now.”

“My coworkers look nervous when they ask me how I’m doing.”

“My family was really supportive at the beginning, but now they don’t even mention the baby and what happened.”

Humans are social creatures. We need each other. We mingle in all kinds of family and work groups and have developed complex interdependent systems to take care of each other when it comes to food, healthcare, entertainment, safety and emotional well-being. Just to get through a routine day, we usually require quite a bit of assistance from other people. We need them to drive the bus to work, sell us coffee and go for a walk with us at lunchtime to discuss the new Star Wars film. We depend on family, friends and professionals to help us stay upright and healthy in the world.

During pregnancy, and in anticipation of birth and the early time with a baby, we generally receive an even higher than normal amount of practical and emotional help from others. This often means more contact and attention from loved ones as well as the healthcare system of doctors, midwives, doulas, etc. People often meet us with high energy and open hearts during the exciting time of transitioning to becoming parents or extending a family.

When something goes wrong, however, the team of friends, family and professionals that was very well prepared for a living baby may not be as up to the task of coping with a loss. People may be awkward, show up at first and then back away pretty quickly or they may have trouble offering anything at all.

There are probably lots of reasons for this. We don’t expect the early end of a pregnancy or death of a baby and each person struggles with his or her own reactions to such events. We also live in a society that tends to minimize grief in general and baby loss in particular. There is discomfort and confusion about the significance of losing someone who was not really well known to the world. Those who were eager to help with a new life may not be ready to help with pain and emptiness. This can be challenging on both sides, meaning that it can be tough to both give and receive support after baby loss.

Challenges Related to Providing Support

Because of anxiety, mistaken assumptions or just feeling at a loss, it can be hard for those in a position to help after loss to do so effectively. Family and friends might wait for cues that they either don’t see or misread. Medical providers may also feel challenged in this situation. They are not always comfortable with the shift in focus from more routine pregnancy and baby care to the raw feelings and needs displayed by someone experiencing perinatal bereavement.

The discomfort from members of the potential support system is often relayed through unclear or unhelpful communication. “Let me know if you need anything” can feel like a pretty vague statement to someone. If “I should wait for her to bring it up” is used as a strategy, it may translate to a grieving person as indifference.

Euphemisms can also be less than helpful during this time. Euphemisms hide or distort direct meaning and in some situations can make information softer or easier to hear while still conveying something useful. When we read a sign that says “please do not throw feminine products in the toilet”, we understand the underlying message and that it’s not a concern about our pitching lipstick or Adele CDs into the loo. But when, after a heartbreaking loss, people speak to us about “letting go”, “moving on” or “closure”, what does that really mean? Implying that there will be an end to feelings about the permanent loss of a loved one can be confusing and painful to someone in the throes of grief. It might just make a person feel misunderstood or alone.

Challenges Related to Receiving Support

As far as making the effort to reach out for help or accepting support, that can be tough too. Most of us are horrified by the thought of being the neon lit person of the recent tragedy. It’s tough to be that person in the social circle, even as a temporary identity. It’s one of the many things you probably wish wasn’t happening right now.

Since the emotional and physical ramifications of baby loss are not often discussed, you may not feel socially entitled to being seen and treated as a bereaved person. People in your situation often have trouble letting others know their feelings or needs. Sometimes, as often happens with a miscarriage or termination due to a devastating medical diagnosis, they may not even let others know that it happened.

Increasing Your Support

Losing a baby means losing someone dear to you, often in an unexpected and traumatic manner. When this happens to you, it’s a high needs time. Maybe you want to talk and maybe you don’t, but you need something. Maybe it’s someone to help you deal with your insurance paperwork, walk your dog, take you to your appointments, bring you groceries or sit with you in silence. Maybe you don’t know what you need, but that doesn’t make you less needy. You’re hurting and it’s your time to lean on others a bit.

If someone is offering help, take him or her up on it. If it seems extra hard, start with something very small. If someone has to be told that you need them, consider doing so. Sometimes people appreciate the information and can step up when prompted. Many people are anxious and uncertain about how to be helpful or if their help is even welcome. Letting them know what you need may make them feel more comfortable as you’ve given them the option of directing their energy in a useful manner.

When your medical providers are not able to give you what you need at this time, consider giving them feedback and/or switching to someone else for your care. At a time when so much is out of your control, remember that you still have choices in this area. Because it can be so hard to process information at this time, and the information you have may be incomplete, you may also want more than one medical professional to help you understand what happened and what it may mean for your future.

If a friend or family in your support system is awkward or insensitive in their help-giving, consider trying to forgive them. Take a break from them if you need to, and try not to make any long term assumptions about the relationship. None of you are in the best place right now.

Maybe you will want to break ties or change your relationships with someone based on their current behavior, but it may be helpful to wait before assuming estrangement with a friend or family member. I recently found out that a decades long rift between two now deceased members of my family was caused by “something to do with pork chops”. It’s hard for me to believe that this fight and the feelings of upset needed to result in the extended separation and tension in the family. Although it can be very hard to forgive emotional injuries, whatever the cause, it may be worth it because it may help you feel better and more peaceful in the long run.

Ask those who are closest to you and who are the most competent to engage others further out in your support network. If no one is local, try using the phone or internet. If you really can’t find someone to help you in the moment, remind yourself that you deserve it anyway and keep looking. As Les Brown said, “Ask for help, not because you’re weak, but because you want to remain strong.”

Grief seems at first to destroy not just all patterns, but also to destroy a belief that a pattern exists. –Julian Barnes

It’s so curious: one can resist tears and ‘behave’ very well in the hardest hours of grief. But then someone makes you a friendly sign behind a window, or one notices that a flower that was in bud only yesterday has suddenly blossomed, or a letter slips from a drawer… and everything collapses. –Colette

You begin to cry and writhe and yell and then to keep on crying; and finally, grief ends up giving you the two best gifts: softness and illumination. —Anne Lamott, Small Victories: Spotting Improbable Moments of Grace

When I was in college, I lived for a time in an old house with four other women. We were all students and most of us knew each other from volunteering together at the local crisis center. One day the house phone rang and I answered it. It was Skip, who was the boyfriend of my roommate Sheila. Skip sounded uncharacteristically serious, asking me if I would please go check on Sheila. He was very short on details, also uncharacteristic of him, but repeated that he would appreciate it if I would check on her.

I hung up and headed down to the basement that contained Sheila’s room. It was dark down there– I never understood how she and the other woman who lived in the basement could stand it. As I started to go down the creaky stairs I began to hear unnerving sounds– snuffling, ripping, swearing and crying. I started to question my choices regarding communal living and answering telephones. I liked Sheila very much, but I was not feeling comfortable with my mission and worried about what I would find in her room.

I started to call her name as I got closer to her door, softly, then louder when she didn’t seem to hear me. After hearing a yelping sound that I thought might have been an acknowledgment, I opened the door. Sheila, red eyed and wet faced, was sitting on the floor surrounded by pieces of white fuzz. It seemed like the stuff was everywhere– stuck to her hair, her clothes and around the room. It took me a while to figure out that she was destroying the thick fuzzy robe that Skip had given her. It took me longer to figure out that Skip had just broken up with her and that as she was shredding the robe she was alternatively throwing the pieces around her room and blowing her nose in them. It took me years longer to notice how Sheila had done exactly what she had needed to do, and a good job of it.

Crazy is a word that gets thrown around a lot. Sometimes it’s used as a slang term for a person who mentally ill or behaving in a mentally ill manner and sometimes it’s just used to describe something out of the ordinary. Sheila’s behavior to me was a big hit of that second kind of crazy– both regarding the range of her behavior that I had previously witnessed and what I had seen in general during my young midwestern life at that point. But mentally ill? Not hardly.

I often hear from those who are grieving a baby loss that they are worried about being crazy. Sometimes they are referring to their behavior, such as making an angry comment to a coworker who has been complaining about her child or spending hours driving aimlessly, afraid to go home. Sometimes it has to do with their thoughts, such as feeling hopeless about the future or being convinced that their previous mistakes in life are to blame for the death of their baby. These are actions that they feel they wouldn’t have done before, thoughts and feelings that they can’t control as much as they would like and experiences they view as unacceptable.

When your life is hit by an unexpected and devastating pile of pain such as losing your baby during or after pregnancy, it’s pretty impossible to maintain your composure at all times. Defenses, which both protect us and get in our way, are down. General internal resources are taxed. Big stuff is being processed. The result can be a bit of psychological and behavioral off-roading and it can be unnerving. People may scream and cry and fluffy matter may be thrown around the room.

On grief we are all shape shifters and it’s hard to know what shape you’re going to be today. You are going to different places inside of yourself and sometimes it will show in unusual behavior, whether you’re alone or with others. Sometimes you just don’t have it in you to be socially appropriate or to make others around you comfortable. It might even be a small relief as you depart from your normal behavior of worrying too much what others think of you. Whether it’s startling or not, all expressions of grief are movement. It may be a rocky and unexpected path, but it’s still the path. And pretending it’s better or different than it is will not take you through this, it just delays the start.

Baby loss is certainly not the same experience as a relationship break up. But I think the fear of behaving crazy in the midst of grief is a common concern. We notice we’re not drawing within the lines sometimes and it’s scary. Of course if your thoughts or behavior are really worrisome or harmful, it’s time to check in with someone (friend, family member or professional) and figure out what you need. I’m not saying that concerning or potentially injurious behavior never happens, just that in my experience it’s much more common that people worry about showing up in an unexpected way in the world, looking weird and being unacceptable, than actually being in a dangerous place.

From what I could see, Sheila moved through her grief and breakup with Skip just fine. She was a sad version of Sheila and then she was just Sheila. The last I heard she had a wonderful family, rewarding work and the same full-on approach to life. My guess is that the flying fuzz incident doesn’t register as a terribly significant event in her past. The time sitting on the floor with her that day, however, made a lasting impression on me. It made me question restraint in the face of grief. It made me want to be more me, whatever that meant, in the moments when I’m hurting. It made me remember Sheila, letting her beautiful grief flag fly, and all the better for it.

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“Everybody has a plan until they get punched in the face.” –Mike Tyson

“The world breaks everyone and afterward many are strong at the broken places.” –Ernest Hemingway, A Farewell to Arms

“Oh Harold, that’s wonderful. Go and love some more.” –“Harold and Maude”, movie written by Colin Higgins, line performed by Ruth Gordon.

FYI– this is NOT going to be a post about the futility of plans.

I am as fond of plan-making as the next person and I have a lot of admiration for the planners extraordinaire who walk into my office. Many of those women and men have developed and executed plan after plan in their lives. They are often impressive plans. Some people have gone to graduate school, some have found fulfillment in volunteer work, some have traveled extensively, some have developed exciting and rewarding careers and some have done all of the above.

The plans we make show something about us. They are our articulated hopes and intentions that we may have been lucky and motivated enough to manifest. The plans we make about our babies are particularly special. These plans tend to involve our most tender feelings of love, hope and a desire to care for someone. They are far reaching, shiny, and beautiful. They involve dreaming on a big scale for something dear– a conjuring of a new person and beloved family member. And when the plans go awry, when we lose our babies, our world gets a little dimmer in a particularly painful way.

Getting punched in the face (and I’m going to go with baby loss as a metaphorical face punch), as Mike Tyson points out, doesn’t put us in the best place to think about plans. We are hurt and knocked off course. We get taken to a different level of experience. Some energy is shifted away from thinking and put into feeling. We stagger back and reevaluate what we have sent out into the world. Stunned and wounded, we wonder what’s next.

When confronted with the grief of baby loss, we often want to jump right back into planning mode. We look for the fast track of grief, the short cut, the best way of doing it. After all, we know how to get things done. If only we could think or plan our way out of pain. If only we could get some assurance of how long, how challenging this road will be and then get to the finish line as soon as possible.

I think at the juncture of being thrown into the grief of baby loss, a moratorium on planning is in order. At least a temporary ban on heavy lifting types of planning. This can be really hard to do. Anxiety and desire to move on to some other experience may drive you to want to keep planning. The pain may feel unbearable.

Realistic concerns about wanting to try again soon for another pregnancy due to age or other factors may also be occupying your mind. You may just be terrified of stopping and feeling. These are all understandable worries. And some distractions, denial and other ways of getting through your day are fine and may be really important. But I do think grief is an experience where it’s really true that “you can run, but you can’t hide”. Some wandering in the pain without looking for the exit is necessary.

So what would I suggest you do instead of rushing to make more plans? I would start with spending some time breathing into your pain and uncertainty. (Sorry if that sounds too groovy but literal breathing while feeling something is the gist here.) I would encourage a respectful mental bow to the you that invested, that tried, that gave your heart to something so lovely. The innocent you that didn’t know you were going to end up here deserves a moment of reverence.

Spend time remembering your pregnancy or your baby as much and in whatever way is right for you. For many people, finding ways to honor their babies is a lifelong priority and this is a good time to start. It’s also a way to honor yourself and your ability to love.

Pretty soon you’ll start working on some new plans. That’s what we do. We move toward the future by zig zagging in the way we think will help us get to the place we think we want to be headed.

You may be especially fearful that your next plan may not work out. You may be especially aware of how wonderful it might be if it does. You may know that you have been changed by letting yourself have plans that were big enough to fail and still matter. But when you’re ready, your head and heart will tug at you again, leading you toward something worth the risk.

“Anyone who has lost something they thought was theirs forever finally comes to realise that nothing really belongs to them.” Paulo Coelho

“But life is just a party and parties weren’t meant to last.” Prince, 1999

A couple of weeks ago there was a lunar eclipse that coincided with a super moon. On the Pacific coast the show in the sky happened at a reasonable hour, and the hillside park near my house was packed with people eager to witness it. Sitting with my partner and our two agitated dogs (apparently people in the Bay Area like to howl at full moon events), I realized that I had missed a call from my mother.

Later, during a quieter moment, I was able to hear her voicemail message to me. My mother sounded happy, with a bit of an excited edge. She said that she, my father and uncle were all in the car and pulled over so that they could watch the moon above a field. The three of them live in the same in the midwestern town and are all in their late 70’s. At a time when my parents and uncle are all usually settled in and watching the late news on TV, they were instead out admiring the way the world (and sun and moon) turns.

My mother cheerfully commented in her message that either this would be their last chance to see a super moon lunar eclipse or that they would be viewing it from the other side (looking down from heaven) when it occurs again in 2033. The darkened ball in the sky in front of me was slowly shifting and growing a bigger Cheshire cat grin. I felt sad about the idea of my family members being gone someday and happy that they had piled in the car to go celebrate something rare and ephemeral.

The idea that we are all transients who will be moving on can be unnerving. It’s hard for me to hold on an ongoing basis the idea that none of us know when we will be finished living, that we don’t know whether we are one of the longer or shorter chapters in the big story, and that we probably will not get much of a say in the matter.

When we have lost a baby, we may feel especially keenly that life is not all about fairness and that our time on the planet is of uncertain length. Many of us have lived through traumatic events and traumatic loss. Many of us live with chronic aches of missing our baby. This makes it all the more notable to me that, either despite these experiences or in part due to them, I’ve met so many people who, after loss, are able to dig in and make the most of their slice of impermanence.

Some people clearly draw a connecting line between what they have learned about sudden loss and not taking anything for granted. Sometimes I think we tend to be so broken after loss that the world we end up putting together has a freshness where more details are noticed. Whatever the cause, I think anyone who is able to see and appreciate the little things in his or her life is lucky. Those who can notice beauty, appreciate kindness and find meaning in an activity or conversation are getting hits of good feelings on a regular basis.

I don’t know any simple, easy, secret for how to find peace with the uncertainty of life, but I do believe we are all having a turn at something. We can’t do it all the time and we can’t do it perfectly, but I do think we can practice noticing where we are and what is part of our turn. It may be our turn to be old or young or in the middle, our turn to be an expert or novice at something, or our turn to be heartbroken or joyous.

The turns, unfortunately, are not orderly or fair, and the pain of our turn may be overwhelming. That’s when we might feel the most grateful for the fact that it will be changing. We’re all somewhere in this moment and will be somewhere else pretty soon. And wherever we are, there is something in front of us that we might want to notice before it’s gone.